Provider Demographics
NPI:1760125280
Name:FAKOLADE, WHITNEY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:
Last Name:FAKOLADE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10837 DOWNEY AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-3706
Mailing Address - Country:US
Mailing Address - Phone:562-825-5923
Mailing Address - Fax:562-825-5992
Practice Address - Street 1:10837 DOWNEY AVE
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-3706
Practice Address - Country:US
Practice Address - Phone:562-825-5923
Practice Address - Fax:562-825-5992
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-14
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86008183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA86008OtherCALIFORNIA BOARD OF PHARMACY